title: Death in the field: teaching paramedics to deliver effective death notifications using the educational intervention "GRIEV_ING".
abstract: BACKGROUND
  Emergency medical services (EMS) personnel are rarely trained in death notification despite frequently terminating resuscitation in the field. As research continues to validate guidelines for the termination of resuscitation (TOR) and reputable organizations such as NAEMSP lend support to such protocols, death notification in the field will continue to increase. We sought to test the hypothesis that a learning module, GRIEV_ING, which teaches a structured method for death notification, will improve the confidence, competency, and communication skills of EMS personnel in death notification.
  
  
  METHODS
  The GRIEV_ING didactic session consisted of a 90-minute education session composed of a didactic lecture, small group breakout session, and role-plays. This was both preceded and followed by a 15-minute case role-play using trained standardized survivors. To assess performance we used a pre-post design with 3 quantitative measures: confidence, competency, and, communication. Paramedics from the local EMS agency participated in the education as a part of continuing education. Pre-post differences were measured using a paired t-test and McNemar's test.
  
  
  RESULTS
  Thirty EMS personnel consented and participated. Confidence and competency demonstrated statistically significant improvements: confidence (percent change in scores = 11.4%, p < 0.0001) and competency (percent change in scores = 13.9%, p = 0.0001). Communication skill scores were relatively unchanged in pre-post test analysis (percent change in scores = 0.4, p = 0.9).
  
  
  CONCLUSIONS
  This study demonstrated that educating paramedics to use a structured communication model based on the GRIEV_ING mnemonic improved confidence and competence of EMS personnel delivering death notification.
authors.affiliation: Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA. Chobgood@iupui.edu
authors.forename: Cherri
authors.initials: C
authors.lastname: Hobgood
authors.forename: Dana
authors.initials: D
authors.lastname: Mathew
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Woodyard
authors.forename: Frances S
authors.initials: FS
authors.lastname: Shofer
authors.forename: Jane H
authors.initials: JH
authors.lastname: Brice
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000193:education*; D001293:Attitude to Death; D003142:Communication; D004496:Education, Continuing / Q000379:methods*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D011368:Professional-Family Relations